The Secret Life of the Psychoanalyst

Perusing the psychoanalytic literature reveals a scattering of papers hinting that even the best theorists in the various schools of psychoanalysis do not, in the privacy of their offices, meticulously practice as prescribed by their specific theoretical orientation. This leads to a number of problems that perhaps it is time to bring out into the light.

For example, Rangell (1974) points out that as analysts we must justify a treatment that goes on for an indeterminate number of years, and it is not sufficient to excuse it by arguing that the patient would be in a mental hospital without it. He points out, as others have also done, that being in analysis four or five times a week can become a way of life and even a substitute for ordinary life and its responsibilities. It is the obligation of the analyst to prevent this from taking place. Rangell is very hostile to the Jungians and the Kleinians. He writes, “Jung's mysticism does not belong to rational psychoanalysis. And more within the analytic body today, the interpretations of some about the earliest months of human life survive their absurdity for a while only by their shock effect” (p. 6).

Rangell introduces what he calls “the syndrome of the compromise of integrity.” This concept has not received the attention it deserves. For Rangell it represents a struggle between the ego and the superego that results from a constant baseline tension between them. In the compromise of integrity, the superego is partially sacrificed and the ego may deny or postpone its own interests. The great enemy of integrity according to Rangell is narcissism, and I heartily agree. Uncontrollable and unsatisfied narcissism forms the strongest motivation to the compromise of integrity. As Rangell puts it, “Instinctual pressures are then to neuroses as ego interests are to the compromises of integrity” (p. 8) and he feels that “the whole question of the relation between the unconscious